Aerosp Med Hum Perform. 2020 Jul 1;91(7):543-564. doi: 10.3357/AMHP.5538.2020.
As NASA and its international partners, as well as the commercial spaceflight industry, prepare for missions of increasing duration and venturing outside of low-Earth orbit, mitigation of medical risk is of high priority. Gynecologic considerations constitute one facet of medical risk for female astronauts. This manuscript will review the preflight, in-flight, and postflight clinical evaluation, management, and prevention considerations for reducing gynecologic and reproductive risks in female astronauts. Relevant gynecological articles from databases including Ovid, Medline, Web of Science, various medical libraries, and NASA archives were evaluated for this review. In particular, articles addressing preventive measures or management of conditions in resource-limited environments were evaluated for applicability to future long-duration exploration spaceflight. Topics including abnormal uterine bleeding, anemia, bone mineral density, ovarian cysts, venous thromboembolism, contraception, fertility, and health maintenance were reviewed. Prevention and treatment strategies are discussed with a focus on management options that consider limitations of onboard medical capabilities. Long-duration exploration spaceflight will introduce new challenges for maintenance of gynecological and reproductive health. The impact of the space environment outside of low-Earth orbit on gynecological concerns remains unknown, with factors such as increased particle radiation exposure adding complexity and potential risk. While the most effective means of minimizing the impact of gynecologic or reproductive pathology for female astronauts is screening and prevention, gynecological concerns can arise unpredictably as they do on Earth. Careful consideration of gynecological risks and potential adverse events during spaceflight is a critical component to risk analysis and preventive medicine for future exploration missions.
随着 NASA 及其国际合作伙伴以及商业航天工业准备进行持续时间越来越长的任务并涉足低地球轨道之外，减轻医疗风险是当务之急。妇科问题是女性宇航员面临的医疗风险之一。本文将回顾女性宇航员在飞行前、飞行中和飞行后的临床评估、管理和预防措施，以降低妇科和生殖风险。从 Ovid、Medline、Web of Science、各种医学图书馆和 NASA 档案等数据库中评估了相关妇科文章，以进行本次综述。特别是，评估了针对资源有限环境下预防措施或疾病管理的文章，以评估其对未来长期探索太空飞行的适用性。审查的主题包括异常子宫出血、贫血、骨密度、卵巢囊肿、静脉血栓栓塞、避孕、生育和健康维护。讨论了预防和治疗策略，重点是考虑到船上医疗能力限制的管理选项。长期探索太空飞行将给维持妇科和生殖健康带来新的挑战。地球轨道外的空间环境对妇科问题的影响尚不清楚，增加的粒子辐射暴露等因素增加了复杂性和潜在风险。虽然减少女性宇航员妇科或生殖系统疾病影响的最有效方法是筛查和预防，但妇科问题也可能像在地球上一样不可预测地出现。在太空飞行期间仔细考虑妇科风险和潜在不良事件是未来探索任务风险分析和预防医学的关键组成部分。
